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Social and Behavioural Determinants of the Difference in Survival among Older Adults in Japan and England

Aida, J; Cable, N; Zaninotto, P; Tsuboya, T; Tsakos, G; Matsuyama, Y; Ito, K; ... Watt, RG; + view all (2018) Social and Behavioural Determinants of the Difference in Survival among Older Adults in Japan and England. Gerontology , 64 (3) pp. 266-277. 10.1159/000485797. Green open access

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Abstract

BACKGROUND: A rapidly ageing population presents major challenges to health and social care services. Cross-country comparative studies on survival among older adults are limited. In addition, Japan, the country with the longest life expectancy, is rarely included in these cross-country comparisons. OBJECTIVE: We examined the relative contributions of social and behavioural factors on the differences in survival among older people in Japan and England. METHODS: We used data from the Japan Gerontological Evaluation Study (JAGES; n = 13,176) and the English Longitudinal Study of Ageing (ELSA; n = 5,551) to analyse all-cause mortality up to 9.4 years from the baseline. Applying Laplace regression models, the 15th survival percentile difference was estimated. RESULTS: During the follow-up, 31.3% of women and 38.6% of men in the ELSA died, whereas 19.3% of women and 31.3% of men in the JAGES died. After adjusting for age and baseline health status, JAGES participants had longer survival than ELSA participants by 318.8 days for women and by 131.6 days for men. Family-based social relationships contributed to 105.4 days longer survival in JAGES than ELSA men. Fewer friendship-based social relationships shortened the JAGES men’s survival by 45.4 days compared to ELSA men. Currently not being a smoker contributed to longer survival for JAGES women (197.7 days) and ELSA men (46.6 days), and having lower BMI reduced the survival of JAGES participants by 129.0 days for women and by 212.2 days for men. CONCLUSION: Compared to participants in England, Japanese older people lived longer mainly because of non-smoking for women and family-based social relationships for men. In contrast, a lower rate of underweight, men’s better friendship-based social relationships, and a lower smoking rate contributed to survival among participants in England.

Type: Article
Title: Social and Behavioural Determinants of the Difference in Survival among Older Adults in Japan and England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1159/000485797
Publisher version: https://doi.org/10.1159/000485797
Language: English
Additional information: © 2018 The Author(s). Published by S. Karger AG, Basel. This article is licensed under the Creative Commons AttributionNonCommercial-NoDerivatives 4.0 International License (https://creativecommons.org/licenses/by-nc/4.0/).
Keywords: Cross-country comparative study, Laplace regression, Cohort study, Mortality, Social relationships
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Epidemiology and Public Health
URI: https://discovery.ucl.ac.uk/id/eprint/10048798
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